Parent Request for Exemption from the

English Language Proficiency Assessment


Oregon House Bill 2655, The Student Assessment Bill of Rights, was recently passed into law and went into effect January 1, 2016. Part of this bill allows parents to excuse students from state summative English language arts (ELA) and mathematics tests by completing a state-provided form and submitting the completed form to the student’s school district. This form only applies to the English Language Proficiency Assessment (ELPA.)


Under Oregon Administrative Rule 581-022-1910, parents may request that their student be exempted from taking the OSAS Online Science and/or ELPA tests to accommodate a student’s disabilities or religious beliefs. To best support school planning, please complete and submit this form to the school office before the school begins testing.


Spanish Form: https://app.smartsheet.com/b/form/d9257c30826e48f8befad848f2e1d675

Select or enter value
Caret IconCaret symbol
Select or enter value
Caret IconCaret symbol

I am requesting that my student be exempt from the Oregon State Assessment indicated below for the 2024-2025 school year:


Signature: By checking the "I Accept" box, you are signing this Request for Exemption Form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Form.

Privacy Notice|Report Abuse